Getting a Better View of Osteoarthritis Trajectories and Variability (OA-TV): systematic reviews and stakeholder engagement

OA-TV

Osteoarthritis is often thought of as a slow, ‘degenerative’ condition that involves ‘wear and tear’, which gets inevitably worse over the years, and is typically put down to just ‘getting older’. New findings seem to show that this is over-simplified. Some patients clearly do get worse – this happens quite quickly for some and more slowly for others. However, in some studies a large number of patients who have been followed for several years do not report their pain or activities getting worse, but most of them do experience episodes of more severe pain and difficulty during that time. So it looks like the course of osteoarthritis is more complicated than we previously thought. We may need to rethink what healthcare professionals tell their patients and how they target treatments at the patients who need them most, and when they most need them. Before going down that road we need to bring all the relevant research findings together to see how strong and consistent they are.

We are planning to do two systematic reviews of the published evidence. The first review will be on whether previous studies have consistently found groups of patients who have different long-term ‘trajectories’ of pain – for example, ‘ongoing pain’, ‘severe pain’ or ‘slowly worsening pain’ or ‘stable mild pain’. The second review will be on how much pain varies from day-to-day and week-to-week and what has been found about things that trigger episodes of worse pain. We’re not sure what the findings of these reviews will show nor what it should mean for patients and professionals. We will therefore run two Stakeholder workshops – one for patients, one for general practitioners and other primary healthcare professionals – to discuss the results of our reviews and their perspective on them.